FORM 1023-EZ for OPEN MEDICAL INC

Field Data
EIN 85-0821118
Case Number EO-2020120-000207
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OPEN MEDICAL INC
Organization’s Mailing Address 3815 WEST CHESTER PIKE
City NEWTOWN SQUARE
State PA
ZIP 19073
Accounting period End 12
Primary contact name LISA PETKUN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC SUGALSKI
DIRECTOR/ CHAIR, PRES & SECT
3815 WEST CHESTER PIKE
NEWTOWN SQ PA 19073

Officer/Director/Trustee Two

MOHIT PRAJAPATI
DIRECTOR/ VICE CHAIR & TREAS.
3815 WEST CHESTER PIKE
NEWTOWN SQ PA 19073

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H02 - Management & Technical Assistance
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ERIC SUGALSKI
Signature Title DIRECTOR/ CHAIR, PRES & SECT
Signature Date 4/27/2020

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